Must Dos and Nice to Haves: Performance Reviews and Continuous Improvement?


There's a very well known cartoon that you might have seen where a caveman offers round wheels to other cavemen who are pulling a cart that has square wheels.

One says, “No thanks,” and the other says, “We're too busy.”

There are different versions of this cartoon out there and I'm not sure what the origins are. There's also the brilliant LEGO version created by Hakan Forss.

I've seen this cartoon used to illustrate the conundrum of Lean or Kaizen-based continuous improvement approaches — the Catch-22 of being too busy to take time to make improvements that might… lead to you being less busy.

When an organization is overwhelmed or understaffed — just trying to survive the day — that's not fertile soil for continuous improvement to bloom. You have to somehow break that cycle of being too busy to improve.

I've seen organizations break that cycle by starting with small Kaizen improvements (what Norman Bodek calls “Quick and Easy Kaizen“). When improvements are small, less time is required and it's easier to make time (although it's still an effort).

That approach was key at Franciscan St. Francis Health, as we explored in our Healthcare Kaizen books and I help other organizations with this approach as a trainer and coach.

There are many possible barriers to improvement. If we ask, “Why are we too busy to improve?” the square wheels that hold us back might include:

  • Having too much patient care work to do (or other value added work, depending on your setting)
  • Being short staffed (open positions or just being understaffed altogether)
  • Other adminstrative duties

It's now “annual performance review” season in many organizations across industries, so that might become another barrier that drags on and on and on.

So, I was inspired to create a crude mockup of a different version of the “square wheels” diagram (with apologies to the original artist):

The cartoon says:

Here, I have some performance improvement methods for you. Those include “Lean” or even the key component of “PDSA” (the core of the Kaizen approach, A3 problem solving, etc.).

No thanks… “too busy doing performance reviews”

The cartoon triggered comments and discussion on LinkedIn when I posted it there the other day.

The irony, right? Spending time judging and evaluating individuals… that's NOT seen as an optional activity for managers and executives.

It's required, so time is made for it. Managers get in trouble if they don't do their reviews.

But, it seems that continuous improvement is, sadly, optional. “As time allows” instead of making time for it. If it's important, you'll find a way to make time for it.

Dr. Deming used to say that the role of a manager is not to be a judge. Annual performance reviews are judging activities. And, it's difficult to separate the performance of an individual from the effects of the system that they work within. Deming said the role of the leader is to help others improve.

Deming isn't the only one who says we should get rid of the performance review. More companies are actually moving in that direction today. Here's a podcast I did with a professor who says we should stop the annual review:

Culbert's book:

More on this topic:

So, if an executive asks, “What alternative do we have?” there actually are alternatives. See articles in the news about this.

Time that was formerly spend judging performance can be repurposed into actually improving the systems that lead to better performance.

It's not just annual performance reviews that can get in the way….

It could be budgeting…

Or figuring out an Electronic Health Record…

Is your organization taking steps to free up time for improvement? Is that a better approach than making Lean, Kaizen, or other continuous improvement methods into a hated mandatory activity, just like budgeting or annual reviews?

What do you think? Please scroll down (or click) to post a comment. Or please share the post with your thoughts on LinkedIn – and follow me or connect with me there.

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Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.


  1. Love the different cartoons! This article reminded me of a book I just finished reading called the new one minute manager. It’s about focusing on the small kaizen changes you can make to your day to make you and your team better.


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